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Abedi M, Shafiee M, Afshari F, Mohammadi H, Ghasemi Y. Collagen-Based Medical Devices for Regenerative Medicine and Tissue Engineering. Appl Biochem Biotechnol 2024; 196:5563-5603. [PMID: 38133881 DOI: 10.1007/s12010-023-04793-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
Assisted reproductive technologies are key to solving the problems of aging and organ defects. Collagen is compatible with living tissues and has many different chemical properties; it has great potential for use in reproductive medicine and the engineering of reproductive tissues. It is a natural substance that has been used a lot in science and medicine. Collagen is a substance that can be obtained from many different animals. It can be made naturally or created using scientific methods. Using pure collagen has some drawbacks regarding its physical and chemical characteristics. Because of this, when collagen is processed in various ways, it can better meet the specific needs as a material for repairing tissues. In simpler terms, collagen can be used to help regenerate bones, cartilage, and skin. It can also be used in cardiovascular repair and other areas. There are different ways to process collagen, such as cross-linking it, making it more structured, adding minerals to it, or using it as a carrier for other substances. All of these methods help advance the field of tissue engineering. This review summarizes and discusses the current progress of collagen-based materials for reproductive medicine.
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Affiliation(s)
- Mehdi Abedi
- Pharmaceutical Science Research Center, Shiraz University of Medical Science, Shiraz, Iran.
- Research and Development Department, Danesh Salamat Kowsar Co., P.O. Box 7158186496, Shiraz, Iran.
| | - Mina Shafiee
- Research and Development Department, Danesh Salamat Kowsar Co., P.O. Box 7158186496, Shiraz, Iran
| | - Farideh Afshari
- Department of Tissue Engineering and Applied Cell Science, School of Advanced Medical Sciences and Technology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamidreza Mohammadi
- Research and Development Department, Danesh Salamat Kowsar Co., P.O. Box 7158186496, Shiraz, Iran
| | - Younes Ghasemi
- Pharmaceutical Science Research Center, Shiraz University of Medical Science, Shiraz, Iran
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
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Rashid M, Karim MN, Saleem H, Najam A, Aasim U, Hashmi MA, Javed M, Ullah Z. A Novel Technique for Thyroplasty Type 1, With Prolene Mesh Implant. J Voice 2024; 38:532-537. [PMID: 34706848 DOI: 10.1016/j.jvoice.2021.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To analyze the efficacy of a modified approach to thyroplasty type one using prolene mesh implant. STUDY DESIGN Interventional study. PLACE AND DURATION OF STUDY Combined Military Hospital Kharian, Pakistan, in Ent department, from July 2020 to Jan 2021. METHODOLOGY Medialization thyroplasty with prolene mesh was performed on the patients satisfying the inclusion criteria. They were analyzed objectively as well as subjectively in terms of Mean Maximum phonation time, maximum word count, and visual analog score about the quality of voice. Data analysis was done with SPSS version 20. Pre-operative and post-operative records were compared using paired sample t-test. RESULTS A total of 39 patients underwent vocal cord medialization with prolene mesh implant. The Mean age for medialization was 41.09 + 13.37. 23 patients were females and 15 were males. 26 patients had unilateral and 13 patients had bilateral vocal dysfunction. 18 of them had vocal dysfunction due to thyroidectomy, eight had idiopathic causes and 13 had miscellaneous. The improvement in mean visual analog score was 2.87 postoperatively. Median maximum phonation time increased about five seconds postoperatively, seven seconds in males, and 4.5 seconds for females. The maximum word count increased from 11.33 preoperatively to 18.28 postoperatively. There were no major complications observed in our study. CONCLUSION These results were comparable to many other studies for vocal cord medialization with different implant materials. But prolene mesh implant offers an easily available yet cost-effective alternative with similar benefits. LEVEL OF EVIDENCE III (Treatment benefits: Non-randomized controlled cohort/follow-up study).
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Affiliation(s)
- Muhammad Rashid
- Department of ENT, Combined Military Hospital (CMH) Kharian, Punjab, Pakistan.
| | | | - Humaira Saleem
- Department of ENT, Combined Military Hospital (CMH) Kharian, Punjab, Pakistan
| | - Atif Najam
- Department of ENT, Combined Military Hospital (CMH) Kharian, Punjab, Pakistan
| | - Umer Aasim
- Department of ENT, Combined Military Hospital (CMH) Kharian, Punjab, Pakistan
| | - Muhammad Ali Hashmi
- Department of ENT, Combined Military Hospital (CMH) Kharian, Punjab, Pakistan
| | - Maaza Javed
- Department of ENT, Combined Military Hospital (CMH) Kharian, Punjab, Pakistan
| | - Zakir Ullah
- Department of ENT, Combined Military Hospital (CMH) Kharian, Punjab, Pakistan
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An Update on the Clinical Efficacy and Safety of Collagen Injectables for Aesthetic and Regenerative Medicine Applications. Polymers (Basel) 2023; 15:polym15041020. [PMID: 36850304 PMCID: PMC9963981 DOI: 10.3390/polym15041020] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/19/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023] Open
Abstract
Soft tissues diseases significantly affect patients quality of life and usually require targeted, costly and sometimes constant interventions. With the average lifetime increase, a proportional increase of age-related soft tissues diseases has been witnessed. Due to this, the last two decades have seen a tremendous demand for minimally invasive one-step resolutive procedures. Intensive scientific and industrial research has led to the recognition of injectable formulations as a new advantageous approach in the management of complex diseases that are challenging to treat with conventional strategies. Among them, collagen-based products are revealed to be one of the most promising among bioactive biomaterials-based formulations. Collagen is the most abundant structural protein of vertebrate connective tissues and, because of its structural and non-structural role, is one of the most widely used multifunctional biomaterials in the health-related sectors, including medical care and cosmetics. Indeed, collagen-based formulations are historically considered as the "gold standard" and from 1981 have been paving the way for the development of a new generation of fillers. A huge number of collagen-based injectable products have been approved worldwide for clinical use and have routinely been introduced in many clinical settings for both aesthetic and regenerative surgery. In this context, this review article aims to be an update on the clinical outcomes of approved collagen-based injectables for both aesthetic and regenerative medicine of the last 20 years with an in-depth focus on their safety and effectiveness for the treatment of diseases of the integumental, gastrointestinal, musculoskeletal, and urogenital apparatus.
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Park SJ, Park YH, Jeong WJ, Cha W. Prolonged persistence of hyaluronic acid after suboptimal vocal fold injection. EAR, NOSE & THROAT JOURNAL 2022:1455613221082619. [PMID: 35324320 DOI: 10.1177/01455613221082619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Hyaluronic acid (HA) is a commonly used injectable material in temporary vocal fold injections (VFI) in patients with unilateral vocal fold paralysis (UVFP). Hyaluronic acid has generally been known for its three-six months of longevity following VFI. Owing to recent advances in cross-linking technologies, the longevity of HA-based materials, including deep-volumizing cross-linked HA used in VFI, has been improved. However, persisting injectable material in the subepithelial space poses undesirable complications following VFI. Herein, we report 2 cases of unexpected persistence of superficially injected cross-linked HA. In the first case, a 70-year-old man with iatrogenic UVFP received VFI with cross-linked HA three years ago and was referred for persistent dysphonia. Previously injected HA spilled out from the vocal fold (VF) when an epithelial incision was made in the subepithelial cystic lesion. In the second case, a 72-year-old woman with iatrogenic UVFP received VFI with cross-linked HA that migrated into the subepithelial space. Diffuse swelling of the injected VF caused dysphonia that lasted for a year. The previously injected HA spilled out when an epithelial incision was made in the swollen VF. Since superficially injected deep-volumizing cross-linked HA can persist for up to three years, laryngologists should be aware of possible sequelae upon suboptimal VFI with cross-linked HA.
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Affiliation(s)
- Sung Joon Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University Hospital, 37985Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Young Hak Park
- Department of Otorhinolaryngology-Head and Neck Surgery, 58976Yeouido St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea
| | - Woo-Jin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, 65462Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Republic of Korea
| | - Wonjae Cha
- Department of Otorhinolaryngology-Head and Neck Surgery, 65462Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Republic of Korea
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Wilson A, Kimball EE, Sayce L, Luo H, Khosla SM, Rousseau B. Medialization Laryngoplasty: A Review for Speech-Language Pathologists. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:481-490. [PMID: 33524276 PMCID: PMC8632480 DOI: 10.1044/2020_jslhr-20-00344] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/18/2020] [Accepted: 11/17/2020] [Indexed: 05/26/2023]
Abstract
Purpose The purpose of this study is to familiarize speech-language-pathologists with the current state of the science regarding medialization laryngoplasty in the treatment of voice disorders, with emphasis on current evidence-based practice, voice outcomes, and future directions for research. Method A literature review was performed in PubMed and Embase using the keywords vocal fold/cord and laryngoplasty, thyroplasty, augmentation, or laryngeal framework. Articles published between 2010 and 2020 were reviewed for data about clinical applications, technical approach, voice-related outcomes, and basic science or clinical innovations with the potential to improve patient care. A synthesis of data was performed from articles meeting the outlined search criteria. Conclusions As key members in the multidisciplinary care of voice disorders, speech-language pathologists need to be informed of current research in medialization laryngoplasty, a procedure commonly used for patients with glottic insufficiency. Advances in anesthetic technique, office-based procedures, and the development of materials with increased bio-tolerability over the past decade have led to innovations in treatment and improved patient outcomes. Recent applications of computational and bioengineering approaches have the potential to provide new directions in the refinement of currently available techniques and the improvement of patient-based treatment outcomes.
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Affiliation(s)
- Azure Wilson
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA
| | - Emily E. Kimball
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN
| | - Lea Sayce
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA
| | - Haoxiang Luo
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN
| | - Sid M. Khosla
- Department of Otolaryngology Head and Neck Surgery, University of Cincinnati College of Medicine, OH
- Neurosensory Disorder Center at UC Gardner Neuroscience Institute, Cincinnati, OH
| | - Bernard Rousseau
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA
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Nassimizadeh A, El-Shummar S, Emery K, Costello D. Vocal fold medialization-A 5-year series of single surgeon consecutive medialization with review of literature. J Eval Clin Pract 2020; 26:281-289. [PMID: 31168894 DOI: 10.1111/jep.13169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/15/2019] [Accepted: 04/18/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION ENT UK released guidelines in 2010 detailing the requisite structure for the creation of a laryngeal intervention clinic. The senior author's practice is the only one regionally that offers this service, and our objective was to review this to determine whether vocal cord medialization injections were showing an improvement in quality of voice for patients. MATERIALS AND METHODS Patients were reviewed in a specialist voice clinic prior to being offered vocal cord injection under local anaesthetic in a separate dedicated weekly clinic. They would be assessed by the senior author and a dedicated voice specialist speech and language therapist (SALT). This would include a preinjection grade, roughness, breathiness, asthenia, and strain (GRBAS), Voice Handicap Index (VHI)-10, and the measuring of maximum phonation time (MPT) with the aid of Opera Vox Apple iPad application. RESULTS Data were available for 186 injections, on patients with a median age of 66 years (interquartile range [IQR]: 51-75), of whom 61% were male. VHI-10 score improved significantly, from a mean of 26.7 to 12.5 (P < .001). A significant improvement in MPT was also observed, from a median of 3.0 to 6.3 (N = 66, P < .001). Improvements in all components of the GRBAS score were also observed (all P < .001), with between 43% and 88% of cases reporting reductions after the procedure. Patients receiving a repeat procedure saw a significantly smaller improvement in VHI-10 than those where it was the primary treatment (mean reduction: 9.8 vs 15.5, P = .018). Analysis of MPT found a significant correlation between the quantity of injection material used and the degree of improvement observed (rho = 0.355, P = .004). CONCLUSION Vocal Cord local anaesthetic medialization injection is a swift, safe, and effective short-term method of improving dysphonia.
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Affiliation(s)
- Abdul Nassimizadeh
- Department of Otolaryngology, University Hospital Birmingham, Birmingham, UK
| | - Suliman El-Shummar
- Department of Otolaryngology, University Hospital Birmingham, Birmingham, UK
| | - Katrina Emery
- Department of Otolaryngology, University Hospital Birmingham, Birmingham, UK
| | - Declan Costello
- Department of Otolaryngology, University Hospital Birmingham, Birmingham, UK
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Granato F, Martelli F, Comini LV, Luparello P, Coscarelli S, Le Seac O, Carucci S, Graziani P, Santoro R, Alderotti G, Barillari MR, Mannelli G. The surgical treatment of unilateral vocal cord paralysis (UVCP): qualitative review analysis and meta-analysis study. Eur Arch Otorhinolaryngol 2019; 276:2649-2659. [PMID: 31375895 DOI: 10.1007/s00405-019-05587-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 07/27/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE The objectives of this meta-analysis were to summarize the key surgical procedures for UVCP and to evaluate which of these is associated with better results in terms of vocal improvement. METHODS A systematic review of the literature was conducted in search of articles focused on the comparison of voice outcome between different techniques for the UVCP treatment. Then, a quantitative analysis was carried out for papers published from 2013 onwards, reporting only adult patients with unilateral paralysis for each study, and each surgical technique was evaluated for its capability of achieving good functional outcomes in terms of GRBAS-I scale and maximum phonation time in seconds (MPT). RESULTS The search identified 1853 publications. A total of 159 articles were stratified and included according to our selection criteria. 21 out of 159 articles were selected for quantitative synthesis. For trans-oral techniques: the mean GRBAS-I scale were 2.33 before injection and 0.41 after injection. The mean MPT before injection were 4.78 and 12.50 after injection. For open techniques the mean GRBAS-I scale were 2.43 before surgery and 0.68 after surgery. For open technique, the mean MPT were 3.50 before surgery and 12.40 after surgery. CONCLUSIONS The two types of techniques lead to an improvement in terms of vocal outcomes emphasizing that from the examined literature an indication emerges to perform an early injection because this could reduce the possible need for a more invasive intervention of permanent medialization in the future.
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Affiliation(s)
- F Granato
- Otorhinolaryngology Clinic, University of Florence, Florence, Italy
| | - F Martelli
- Otorhinolaryngology Clinic, University of Florence, Florence, Italy
| | - L V Comini
- Otorhinolaryngology Clinic, University of Florence, Florence, Italy
| | - P Luparello
- Otorhinolaryngology Clinic, University of Florence, Florence, Italy
| | - S Coscarelli
- Phoniatrics Unit, University Hospital Careggi, Florence, Italy
| | - O Le Seac
- Phoniatrics Unit, University Hospital Careggi, Florence, Italy
| | - S Carucci
- Phoniatrics Unit, University Hospital Careggi, Florence, Italy
| | - P Graziani
- Head and Neck and Robotic Surgery, Azienda Ospedaliero Universitaria Careggi, 50141, Florence, Italy
| | - R Santoro
- Head and Neck and Robotic Surgery, Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, CAP 50134, Firenze, Italy
| | - G Alderotti
- Department of Statistics Science, University "La Sapienza" of Rome, Rome, Italy
| | - M R Barillari
- Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuditta Mannelli
- Head and Neck and Robotic Surgery, Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, CAP 50134, Firenze, Italy.
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Glikson E, Sagiv D, Eyal A, Wolf M, Primov-Fever A. The anatomical evolution of the thyroid cartilage from childhood to adulthood: A computed tomography evaluation. Laryngoscope 2017; 127:E354-E358. [DOI: 10.1002/lary.26644] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 03/06/2017] [Accepted: 03/27/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Eran Glikson
- Department of Otolaryngology-Head and Neck Surgery
| | - Doron Sagiv
- Department of Otolaryngology-Head and Neck Surgery
| | - Ana Eyal
- Department of Diagnostic Imaging; Neuroradiology Unit, the Sheba Medical Center; Tel-Hashomer
| | - Michael Wolf
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Adi Primov-Fever
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
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Sagiv D, Eyal A, Mansour J, Nakache G, Wolf M, Primov-Fever A. Novel Anatomic Characteristics of the Laryngeal Framework. Otolaryngol Head Neck Surg 2016; 154:674-8. [DOI: 10.1177/0194599815627781] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 12/30/2015] [Indexed: 11/17/2022]
Abstract
Objective The thyroid cartilage (TC) in men has a more prominent thyroid notch and a narrower interlaminae angle (ILA) as compared with women. Anatomy textbooks classically stipulate that the ILA is 90° in men and 120° in women. Our observation, based on thyroid chondroplasty operations, of a much narrower angle led to the current investigation. Study Design Cohort imaging study. Setting Tertiary academic referral center. Subjects and Methods Computed tomography angiography neck images of adult patients were studied. The ILA was measured on 2 axial planes: at the level of the vocal processes (and the upper portion of thyroarytenoid muscles) and 5 mm superior and parallel to the former. The anterior projection of the TC and the vertical dimensions of the midline cricothyroid membrane (CTM) were also measured. Results A total of 126 patients were included in the study. The average ILAs were 63.5°±20.6° and 93.3°±16.6° for men and women, respectively ( P < 10−14), and were significantly narrower at the upper level in comparison with the vocal process level ( P < 10−7 for men, P = .004 for women). The anterior projection of the TC in men was more prominent as compared with women ( P = .0003) and significantly correlated with the ILA ( P = .0159). The length of the midline CTM was 11.1±2.3 mm in men and 10.3±1.7 mm in women ( P = .0355). Conclusions The ILA is narrower than that reported in the classic anatomy textbooks. In male patients, the upper part of the TC becomes narrower and projects anteriorly like a “jug’s spout.” The mean vertical dimension of the midline CTM was 10 to 11 mm.
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Affiliation(s)
- Doron Sagiv
- Department of Otolaryngology–Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel
| | - Ana Eyal
- Department of Diagnostic Imaging, Neuroradiology Unit, Sheba Medical Center, Tel-Hashomer, Israel
| | - Jobran Mansour
- Department of Otolaryngology–Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel
| | - Gabriel Nakache
- Department of Otolaryngology–Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel
| | - Michael Wolf
- Department of Otolaryngology–Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adi Primov-Fever
- Department of Otolaryngology–Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Tigges M, Hess M. [Glottis injection to improve voice function : Review of more than 500 operations]. HNO 2015; 63:489-96. [PMID: 26104911 DOI: 10.1007/s00106-015-0029-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hoarseness due to insufficient glottal closure can be treated by injection laryngoplasty (augmentation). Vocal fold injections can be performed as an in-office procedure or under general anesthesia. As injection materials have recently improved and different injection approaches are available, injection laryngoplasties are performed much more frequently. OBJECTIVES Advantages and disadvantages of injection materials, laryngeal approaches, and differential indications are described. MATERIALS AND METHODS Literature research and experience of more than 500 laryngeal injection procedures are provided. RESULTS AND CONCLUSIONS Sophisticated use of available injection materials can provide a satisfying improvement of voice function with minimal patient discomfort. Adequate indication is mandatory for a favorable outcome. Further improvement regarding biocompatibility and the duration of injection materials is desirable.
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Affiliation(s)
- M Tigges
- Städtisches Klinikum Karlsruhe gGmbH, Moltkestraße 90, 76133, Karlsruhe, Deutschland,
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